Unknown Individual – Sports Medicine (Internal Medicine) Physician, NPI 1275633455
Sports Medicine (Internal Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for Unknown Individual
6600, South Yale Avenue, Southridge Estates, Tulsa, Tulsa County, Oklahoma, 74137, United States
SUITE 1400
TULSA, OK 741363347
Phone:
Type: Mailing
200, South Yale Avenue, White City, Tulsa, Tulsa County, Oklahoma, 74112, United States
TULSA, OK 741367816
Phone: (918) 494-4460
Fax: (918) 494-4442
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 74136)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| Physician Assistant | OK | |
| Physician Assistant | OK | |
| Nurse Practitioner | OK | |
| - | OK | |
| - | OK | |
| Nurse Practitioner | OK | |
| P O D I A T R Y | OK | |
| Pediatric Medicine | OK | |
| - | OK |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.